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Veterinary clinical pathology2019; 48(4); 668-676; doi: 10.1111/vcp.12811

Intra- and inter-rater agreement for the detection of band neutrophils and toxic change in horses.

Abstract: The detection of band neutrophils and toxic change via microscopic blood smear review is vitally important, as their presence indicates systemic inflammation. However, in-clinic evaluation of WBC morphology is often limited. Objective: We aimed to determine the agreement between expert raters in the detection of bands and toxic change. Methods: Three board-certified clinical pathologists each evaluated 109 blood smears from horses with acute disease, and 19 control smears from healthy horses. The pathologists determined if bands were present, and if so, the percentage of bands present. They also determined if toxic change was present, and if so, the grade of toxic change. Intra-rater agreement was evaluated using 12 duplicate blood smears. Agreement on the presence of bands between pathologists and an in-clinic hematology analyzer was evaluated. Results: Intra-rater agreement was substantial to almost perfect. Agreement between pathologists for the detection of bands was moderate, but when pathologists agreed bands were present, there was excellent agreement on the percentage of bands and mature neutrophils. Agreement between pathologists for the detection of high-grade, clinically relevant toxic change was fair. When pathologists agreed high-grade toxic change was present, there was fair agreement on Döhle bodies and cytoplasmic basophilia and poor agreement on cytoplasmic vacuolation. Agreement between individual pathologists and the in-clinic hematology analyzer for the indication of bands was fair to moderate. Conclusions: Consistent identification of bands and toxic change is challenging, even for highly trained personnel. It is, thus,not surprising that in-clinic blood smear evaluation of WBC morphology by non-experts could be inadequate.
© 2019 American Society for Veterinary Clinical Pathology.
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Publication Date: 2019-12-10 PubMed ID: 31823397DOI: 10.1111/vcp.12811Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research focuses on the accuracy of expert assessment in identifying band neutrophils and toxic change in horses’ blood smear tests. It evaluates the consistency of the evaluations made by three experienced pathologists, and how well their assessments match those done by a clinical hematology analyzer.

Research Methodology

  • The study involved three board-certified clinical pathologists who examined a total of 128 blood smear tests. Out of these, 109 came from horses with acute disease, while 19 were controls from healthy horses.
  • The pathologists sought to identify if band neutrophils were present, and if they were, the proportion involved. They also attempted to detect any toxic changes, along with determining their grade.
  • Intra-rater agreement, which gauges the consistency of evaluations made by the same individual on two or more occasions, was evaluated using 12 duplicate blood smears.
  • The study also sought to assess the agreement between individual pathologists and an in-clinic hematology analyzer, mainly focusing on the indication of band neutrophils.

Results of the Study

  • The intra-rater agreement was found to range from substantial to almost perfect, signifying high consistency in the individual assessments of the pathologists.
  • However, the agreement between the different pathologists in the detection of band neutrophils was moderate. But when they agreed that band neutrophils were present, their agreement on the percentage was excellent.
  • The agreement for the detection of high-grade toxic change (clinically significant change) was fair. Further, if they agreed on its presence, their agreement was fair on Döhle bodies and cytoplasmic basophilia (specific types of toxic changes), but poor on cytoplasmic vacuolation (another form of toxic change).
  • When comparing individual pathologists’ evaluations with the in-clinic hematology analyzer, the agreement was fair to moderate.

Conclusion from the Study

  • Even for highly trained personnel, consistently identifying band neutrophils and toxic change is challenging. This difficulty could explain why non-expert in-clinic blood smear evaluations might be inadequate.

Cite This Article

APA
Fernandez NJ, Gilroy CV, Wagg CR, Kwong GPS, Roy MF. (2019). Intra- and inter-rater agreement for the detection of band neutrophils and toxic change in horses. Vet Clin Pathol, 48(4), 668-676. https://doi.org/10.1111/vcp.12811

Publication

Veterinary clinical pathology
ISSN: 1939-165X
NlmUniqueID: 9880575
Country: United States
Language: English
Volume: 48
Issue: 4
Pages: 668-676

Researcher Affiliations

Fernandez, Nicole J
  • Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Gilroy, Cornelia V
  • Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada.
Wagg, Catherine R
  • University of Calgary, Faculty of Veterinary Medicine, Calgary, AB, Canada.
Kwong, Grace P S
  • University of Calgary, Faculty of Veterinary Medicine, Calgary, AB, Canada.
Roy, Marie-France
  • University of Calgary, Faculty of Veterinary Medicine, Calgary, AB, Canada.

MeSH Terms

  • Animals
  • Automation
  • Hematologic Tests / veterinary
  • Horse Diseases / blood
  • Horses
  • Inflammation / blood
  • Inflammation / veterinary
  • Leukocyte Count / veterinary
  • Leukopoiesis
  • Neutrophils / cytology
  • Observer Variation
  • Retrospective Studies

Grant Funding

  • 1-419529-1142-60104-8000-9999 / University of Saskatchewan

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Citations

This article has been cited 3 times.
  1. Perez-Ecija A, Buzon-Cuevas A, Aguilera-Aguilera R, Gonzalez-De Cara CA, Mendoza FJ. Blood Storage Conditions Affect Hematological Analysis in Samples From Healthy Donkeys and Donkeys With Experimentally-Induced Endotoxemia. Front Vet Sci 2020;7:640.
    doi: 10.3389/fvets.2020.00640pubmed: 33134340google scholar: lookup
  2. O Toole DS, Williams TL, Hare CHZ. The Value of Neutrophil Cell Population Data Parameters as Markers of Systemic Inflammation in Dogs and Cats. Vet Clin Pathol 2025 Jun;54(2):78-86.
    doi: 10.1111/vcp.70029pubmed: 40476643google scholar: lookup
  3. Sun P, Jeffery U. Decreased antithrombin activity and inflammation in cats. J Feline Med Surg 2021 Jun;23(6):498-506.
    doi: 10.1177/1098612X20960400pubmed: 33025836google scholar: lookup
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